A deviated septum is a well known factor causing nasal obstruction in people. However, many patients with a deviated septum will also state that there are times when they can breathe just fine from their nose. As such, can a deviated septum truly be the cause of their nasal obstructive symptoms? Shouldn’t the obstruction be constant?

The blunt answer is ABSOLUTELY nasal obstruction can be intermittent OR constant with a deviated septum!!! It’s more a question of degree.

To begin with, a deviated septum is when the wall that separates the right and left nasal cavities is bent one way (green arrow in left illustration) instead of being perfectly straight (right illustration).

If there is no mucosal swelling, a person with a deviated septum is able to breathe from both sides just fine. However, if there is the slightest bit of mucosal swelling from turbinate hypertrophy, allergies, upper respiratory infection, or any other environmental irritation, the side that is more narrow will obstruct much more readily with less swelling given there is just “less room” for swelling to occur before obstruction occurs.

Below is the same exact nose and septum as above, but with mucosal swelling present. Read more »

Though most people like the professional nose whistler shown here require an instrument to enable the nose to whistle, in others it occurs naturally due to unique anatomic features within the nose.

Why might someone’s nose whistle?

Septal Perforation

The most common reason it may occur constantly is due to a hole in the septum (septal perforation). The septum is a wall that divides the right nasal cavity from the left side. Normally, it should be straight and without any openings.

However, when a hole is present in the septum and it is in just the right size and place, whenever air is breathed in and out of the nose, it will whistle. In this situation, the hole is the “window” of the whistle and the nose itself is the mouthpiece.

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